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August 2016  Volume 9, Number 8        

long term care

Get Your Money’s Worth by Using Your Preventive Benefits

Did you know your health plan covers a variety of preventive services at no out-of-pocket cost to you? You may be leaving money on the table if you’re not taking advantage!

President Obama signed the Patient Protection and Affordable Care Act—also known as Obamacare or the Affordable Care Act—into law in March 2010. The law made many changes to health coverage, including requiring health plans to cover certain preventive services outside the deductible. This is true for plans purchased on the government’s health insurance marketplace at www.healthcare.gov, individually or through an employer.

What does this mean for you? You can receive certain preventive treatments, such as vaccines, mammograms and more, without paying out-of-pocket. Unlike most treatments, you can access these preventive services even before you’ve paid the deductible, the amount you must pay out-of-pocket before your health plan begins paying for other covered services.

Preventive services help to prevent or detect health problems. Examples of preventive care are health checkups, wellness screenings and immunizations. In addition to improving health, evidence shows that preventive care saves money by avoiding future treatments.

The U.S. Preventive Services Task Force reports that measures such as counseling adults to quit smoking, screening for colorectal cancer, and providing influenza vaccinations, reduce mortality at a cost savings.

Free preventive services covered under the Affordable Care Act include:

For adults:

  • Immunizations
  • Blood pressure and cholesterol screenings
  • Obesity and Type 2 diabetes screenings
  • Depression screening
  • Alcohol misuse screening and counseling
  • Colorectal cancer screening
  • Diet counseling for adults at higher risk for chronic disease

For women:

  • Contraceptives
  • Well-woman visits
  • Osteoporosis and anemia screenings
  • Prenatal care
  • Mammograms and breast cancer counseling
  • Anemia screening
  • Comprehensive breastfeeding support and counseling

For children

  • Developmental screenings
  • Autism screening
  • Behavioral assessments
  • Vision and oral health screenings
  • Depression screening
  • Immunization vaccines for children from birth to age 18

You can find a complete, detailed list of the preventive treatments health plans must cover at www.healthcare.gov/coverage/preventive-care-benefits.

What’s Free/What’s Not Free

To take advantage of these services, you need to know what is available and you have to ask for the FREE service. If you just ask for a checkup, you might be charged a copay if your healthcare provider thinks the visit is for a particular issue. Instead, be specific about what you need.

For instance, call and say, “I want my free well-woman visit” or “I need free immunizations for my four-year-old.” Always check your bill to make sure you are not being charged for a service that should have been free.

Health plans do not have to cover follow-up treatments that are discovered through screening. For example, if during a free screening your provider discovers you have diabetes, you will be charged for any resulting treatment.

The type of contraceptives offered varies between insurance carriers and you might have to pay more if you want a different option. Plus, a brand name instead of a generic could cost you more.

Before you visit a doctor or request an exam, review your coverage to understand which services are provided for free or which services require payment. These services are free only when delivered by a doctor or other provider in your plan’s network.

Not sure what your health plan covers? Please call us for a policy review.


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In this issue:

This Just In...

Get Your Money’s Worth by Using Your Preventive Benefits

Annuities Protect Retirees from Volatile Markets

Republicans’ Alternative to Obamacare

Insuring Your College Student


The information presented and conclusions within are based upon our best judgment and analysis. It is not guaranteed information and does not necessarily reflect all available data. Web addresses are current at time of publication but subject to change. SmartsPro Marketing and The Insurance 411 do not engage in the solicitation, sale or management of securities or investments, nor does it make any recommendations on securities or investments. This material may not be quoted or reproduced in any form without publisher’s permission. All rights reserved. ©2016 The Insurance 411. www.theinsurance411.com Tel. 877-762-7877.